Document text
Principal Investigator: Jane N Bolin
Organization: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
Fiscal Year: 2024
Award: $817,483
Funding agency: National Center for Complementary and Integrative Health
PROJECT SUMMARY
Despite a range of therapeutic approaches, chronic musculoskeletal pain (CMP) persists at a high rate, creating a public health burden. Our long-term goal is to increase access and scalability of evidence-based interventions while addressing pain care disparities for rural individuals with limited resources and/or endure long distances to specialty pain care. We will conduct a hybrid implementation-effectiveness trial, guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework in diverse healthcare systems and communities across the United States in Texas and South Carolina focusing on rural health populations. Specifically, in our UG3 phase, we aim to plan and evaluate our Auricular Point Acupressure Self-Management (APA-SM) program integrated into rural health care and communities. Our team has accumulated extensive evidence supporting the use of APA-SM in decreasing pain intensity, reducing pain interference, and improving physical function. To maximize self-management of pain, we successfully developed and tested a smartphone APA app, an integral component of our APA-SM program, so patients can learn to self-administer APA. We also used ecological momentary assessment integrated into our app to measure real-world outcomes with participants able to self-monitor their progress using this as an innovative behavior change strategy. Our APA-SM program is theory-based according to Bandura’s self-efficacy model, toward successful initiation and maintenance of participants’ behavior change.
In the UG3 phase, we will work with the NIH Pragmatic Trials Collaboratory Coordinating Center and collaborate extensively with our stakeholders to plan, implement, evaluate, and sustain our intervention. In the UH3 phase, using a pragmatic, randomized clinical trial, we will evaluate the clinical effectiveness of our 4-week APA-SM program. We will compare 3 groups: self-guided APA-SM, APA-SM + in-person training, and education control. The primary outcomes are pain intensity, pain interference, and function; the secondary outcomes are based on the HEAL Clinical Pain Core common data elements, and analgesic use, up to a 6-month follow-up. We will also evaluate implementation outcomes, cost-effectiveness, and predictive factors for APA-SM treatment response. A two-phase design in our UH3 will include an initiation (support for buy-in) and maintenance (no support provided) phase.
Terms: <21+ years old><Access to Care><Active Follow-up><Acupressure><Acupuncture Therapy><Acupuncture procedure><Address><Adherence><Adopted><Adult><Adult Human><Advocate><Analgesic Agents><Analgesic Drugs><Analgesic Preparation><Analgesics><Anodynes><Antinociceptive Agents><Antinociceptive Drugs><Assess implementation><Caring><Cell Phone><Cellular Phone><Cellular Telephone><Cephalalgia><Cephalgia><Cephalodynia><Clinic><Clinical><Clinical Management><Clinical effectiveness><Collaborations><Collection><Common Core><Common Data Element><Communities><Computers><Cost Analyses><Cost Analysis><Cranial Pain><Data><Demographic Factors><Disparities><Disparity><Drugs><Ear><Ecological momentary assessment><Education><Educational aspects><Educational process of instructing><Electronic Health Record><Eligibility><Eligibility Determination><Enrollment><Ensure><Equity><Event><Evidence based intervention><Exhibits><Fostering><Goals><Guidelines><Head Pain><Headache><Health><Health Care Systems><Health Services Accessibility><Healthcare><Healthcare Systems><History><Implementation assessment><Individual><Intervention><Intervention Strategies><Ischemic Compression><Learning><Maintenance><Measures><Medication><Methods><Migraine><Migraine Headache><Mobile Phones><Modeling><Monitor><Motivation><Musculoskeletal Pain><NIH><National Institutes of Health><Non-pharmacologic Therapy><Nonpharmacologic Intervention><Nonpharmacologic Therapy><Nonpharmacologic approach><Nonpharmacologic treatment><Outcome><Pain><Pain Control><Pain Therapy><Pain intensity><Pain interference><Pain management><Painful><Participant><Patient Compliance><Patient Preferences><Patient-Centered Care><Patients><Persons><Pharmaceutical Preparations><Phase><Physical Function><Population Heterogeneity><Predictive Factor><Primary Care><Procedures><Protocol><Protocol Screening><Protocols documentation><Provider><Public Health><QOL><Quality Control><Quality of life><RE-AIM><Randomized><Randomized, Controlled Trials><Reach, Effectiveness, Adoption, Implementation, and Maintenance><Recording of previous events><Reporting><Research><Research Resources><Resources><Rural><Rural Health><Rural Population><Rural group><Rural people><Sample Size><Self Administered><Self Administration><Self Efficacy><Self Management><Societies><South Carolina><Specialty><System><Tablets><Teaching><Testing><Texas><Therapeutic><Time><Training><United States><United States National Institutes of Health><Work><access to health services><access to services><access to treatment><accessibility to health services><active followup><acupuncture><adulthood><arm><assess cost><assess effectiveness><availability of services><behavior change><cancer pain><care access><care as usual><chronic MSK pain><chronic musculoskeletal pain><chronic pain><chronic pain control><chronic pain intervention><chronic pain management><chronic pain therapy><chronic pain treatment><clinical pain><clinical practice><co-morbid><co-morbidity><collaboratory><community partners><community-based partners><comorbidity><compare to control><comparison control><cost assessment><cost effectiveness><cost evaluation><cost-effectiveness indices><cost-effectiveness ratio><design><designing><determine effectiveness><digital><disability><diverse populations><drug/agent><effectiveness and implementation trial><effectiveness assessment><effectiveness evaluation><effectiveness outcome><effectiveness-related outcomes><effectiveness/implementation hybrid><effectiveness/implementation hybrid trial><effectiveness/implementation trial><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><empowerment><enroll><evaluate cost><evaluate effectiveness><evaluate implementation><evaluation of implementation><evidence base><examine cost><examine effectiveness><flexibility><flexible><follow up><follow-up><followed up><followup><geographic population><head ache><health care><health care settings><health equity><health service access><health services availability><healthcare settings><heterogeneous population><histories><iPhone><implementation cost><implementation evaluation><implementation investment><implementation outcomes><improved><incremental cost-effectiveness><incrementally cost effective><innovate><innovation><innovative><interventional strategy><machine statistical learning><medical specialties><non-drug therapy><non-drug treatment><nondrug therapy><nondrug treatment><opiate consumption><opiate crisis><opiate drug use><opiate intake><opiate use><opioid consumption><opioid crisis><opioid drug use><opioid epidemic><opioid intake><opioid use><pain killer><pain medication><pain outcome><pain reduction><pain reliever><pain self-management><pain treatment><pain-related outcome><painkiller><patient adherence><patient cooperation><patient health information><patient health record><patient medical record><pilot test><population diversity><population health><pragmatic effectiveness trial><pragmatic trial><primary care setting><primary outcome><programs><randomisation><randomization><randomized control trial><randomized, clinical trials><randomly assigned><reach, efficacy, adoption, implementation, and maintenance><recruit><reduce pain><response><response to therapy><response to treatment><routine care><rural area><rural disparities><rural health care><rural healthcare><rural individual><rural location><rural region><satisfaction><secondary outcome><self-management program><service availability><skills><smart phone><smartphone><statistical and machine learning><theories><therapeutic response><therapy response><treat chronic pain><treatment access><treatment as usual><treatment response><treatment responsiveness><usual care>